1. Field of the Invention
The present invention relates to hydraulic intraocular lenses and lens systems. Specifically, the present invention relates to hydraulic intraocular lenses and lens systems that address the compromising effects of capsulorhexis and the centripetal anterior forces that are lost thereby, that restore and maintain the spacing between the anterior and posterior capsule that is lost by crystalline lens extraction and that would otherwise result in the shrink-wrapping and fibrosing of the capsule and the loss of the accommodating function thereof, and that effect accommodation by employing the mechanisms that previously effected accommodation via the crystalline lens.
2. Description of the Related Art
When vision is compromised by cataracts, remediation typically comprises surgical extraction of the cataractous lens and the implantation of a single-focus intraocular lens. While this surgery would be an ideal opportunity to implant an intraocular lens that is also accommodative, none of the accommodative implants available to date provides the combination of the acuity of vision and the range of accommodation available from the combination of single focus implants and a pair of glasses having progressive lenses.
Hydraulic lenses, as described in the November, 1940 issue of the Journal of the Optical Society of America (JOSA), typically comprise a transparent plate to which is affixed a transparent elastically reconfigurable membrane, a refractive medium a portion of which is contained in the space between the membrane and the plate and the remainder of which is contained in an external reservoir, and a means for transferring refractive medium to and from the reservoir to the space, changing the curvature of the membrane and thus the diopter power of the lens thereby.
U.S. Pat. No. 4,261,655 to Honigsbaum, discloses a hydraulic lens in which the plate is an eyeglass lens, the external reservoir is a bellows, and the transfer means is a brow lever that flexes and relaxes the bellows, thus transferring refractive medium to and from the hydraulic lens and effecting change in diopter power thereby.
Published U.S. Patent Application 2011/0118834 to Lo et at discloses a hydraulic accommodative intraocular lens for implantation in the capsule of an eye from which the crystalline lens has been extracted, and in which the reservoir is in direct contact with the capsule equator.
U.S. Pat. No. 7,261,737 B2 to Esch et al and U.S. Pat. No. 7,985,253 B2 to Cumming disclose hydraulic lenses that are held in place in capsules by haptics that allow for space between the haptics and the capsulorhexis-compromised anterior capsule, and thus shrink-wrapping by, and fibrosing of, the capsule, and, as confirmed experimentally by Allo et al, Study of the force dynamics at the capsule interface related to ciliary body stimulation in a primated model, J Refrac Surg 2015 February 31(2) pp 124-8, capsular forces intended to effect accommodation do not long survive shrink-wrapping.
Published U.S. Patent Application 2009/0018652 to Hermans et al discloses a two lens accommodative intraocular lens system that maintains separation between the anterior and posterior capsules and, because this prevents shrink-wrapping, continues to function accommodatively as confirmed by the continuing functionality of Synchrony Vu™ implants.
Hermans also discloses a plurality of actuating mechanisms for two-lens accommodative intraocular lenses, none of which anticipate either the hydraulic lens configurations or the actuating mechanisms of the present invention.
Published U.S. Patent Application 2016/0000558 (Honigsbaum) discloses tensioning rings for attachment to anterior capsules to restore at least a portion of the centripetal anterior capsular forces lost by capsulorhexis, spacer-actuators that prevent shrink-wrapping, and haptics-and-bellows actuated hydraulic accommodative intraocular lenses the bellows of which also serve as external reservoirs.
Published U.S. Patent Application 2012/0303118 (DeBoer et al) discloses a flexible bag for implantation in an eye from which the crystalline lens has been extracted, the bag to be filled with a compatible refractive medium after implantation, and some of the bag materials and refractive media are appropriate for the present invention as well.
Public domain lenses and lens systems are also described and illustrated herein for purposes of clarity of illustration and explanation.